Symptoms of polymyalgia rheumatica (PMR) may develop suddenly – even overnight, in some cases – or they may develop gradually over several weeks. Both sides of the body are typically affected equally. However, pain and stiffness may be more prominent on one side than the other, particularly at the earliest stages of development.

The characteristic symptoms of PMR are moderate to severe pain and stiffness in and around the neck, shoulders and hips. This pain and stiffness is typically worse in the morning and after periods of inactivity (e.g., long car rides, watching movies). Pain generally improves over the course of the day but lasts at least 30 minutes.

Pain and stiffness may decrease the ability to actively move the neck, shoulders and hips and may be severe enough to rouse a patient from sleep. PMR patients may have trouble with the following and similar actions because of pain and stiffness:

• Getting out of bed
• Getting dressed
• Rising from a chair
• Getting into or out of automobiles
• Lifting arms overhead

The symptoms of PMR are often difficult to pinpoint, but the pain is usually said to come from the muscles around the joints. Most of the pain and stiffness occurs around the neck, shoulders and hips, but joints in other areas of the body may also ache. The affected areas may be tender to the touch, but this does not always occur.

Although muscles feel stiff and painful, muscle strength is usually normal. PMR does not damage muscle tissue. When muscle weakness is present, it is usually a problem due to muscle atrophy (deterioration) from disuse because of pain.

Pain and stiffness are not the only symptoms of PMR. Other symptoms may include:

• Arthritis (joint inflammation). The small joints of the hands and feet of PMR patients may develop arthritis, which is typically mild. In contrast to other forms, arthritis related to PMR may be brief and responds well to treatment.
  
  
• Swelling (edema). An increase in fluids in the tissues of the hands, wrists, ankles and/or tops of the feet may cause swelling. Knee joints may also swell. The swelling in the wrists may lead to symptoms of carpal tunnel syndrome, such as numbness and tingling in the fingers. Carpal tunnel symptoms occur in less than a quarter of PMR cases.
  
  
• Pitting edema. This occurs when a depression remains in swollen tissue after it is pressed. It usually accompanies other signs of PMR but may be the first sign noticed.
  
  
• Other symptoms, including:
  
  
• • Slight fever
  • Malaise (general weakness and unwell feeling)
  • Unexplained weight loss
  • Loss of appetite
  • Depression
  • Night sweats
  • Fatigue